Dr. David is the first doctor I've ever spoken to to even hint that I might have endo, which is odd since I have pretty much all of the identified symptoms (and often those with endo have no symptoms at all). Yet another thing to ask my RE about...
From medicinenet.com
What are endometriosis symptoms?
Most women who have endometriosis, in fact, do not have symptoms. Of those who do experience symptoms, the common symptoms are pain (usually pelvic) and infertility. Pelvic pain usually occurs during or just before menstruation and lessens after menstruation. Some women experience pain or cramping with intercourse, bowel movements and/or urination. Even pelvic examination by a doctor can be painful. The pain intensity can change from month to month, and vary greatly among women. Some women experience progressive worsening of symptoms, while others can have resolution of pain without treatment. Other symptoms related to endometriosis include:
lower abdominal pain, (check)
diarrhea and/or constipation, (check)
low back pain, (check)
irregular or heavy menstrual bleeding, (check)
or blood in the urine.
...most cases of endometriosis are diagnosed in women aged around 25-35 years
Endometriosis is more commonly found in white women as compared with African American and Asian women. Studies further suggest that endometriosis is most common in taller, thin women with a low body mass index (BMI). Delaying pregnancy until an older age is also believed to increase the risk of developing endometriosis.
...the only accurate way of diagnosing endometriosis is at the time of surgery, either by opening the belly with large-incision laparotomy or small-incision laparoscopy.
My RE's e-mail response...
"As for endometriosis, I would not be surprised if you have endo. There is an association between endometriosis and uterine malformations. There is some data to suggest that treating mild endometriosis can improve chances of getting pregnant, though the data is highly controversial. Most data suggests that IVF is the best treatment. We can discuss further, I would be open to doing a laparoscopy, but you have to weigh the risks of surgery vs. risks of IVF."
Because two surgeries isn't enough, why not another, right? Don't you just love how IVF is the answer to any and all IF questions? The funny thing is that if it doesn't work, it'll just be "let's try it again!". This is completely insane.
The problem with endo is the way to diagnosis is so invasive that most drs won't do it until you've had a few failed attempts. I pushed my RE to do the lap after 1 failed IUI, but he only conceded b/c I had what they thought was an endometrioma on my ovary which showed up in a U/S. Definitely something to ask about.
ReplyDeleteKate, we went to IVF instead of having the lap to test for endo. H and I wonder all the time if Endo is my Dx, but IVF worked for us and we wouldn't have been able to get two IVFs in on our insurance if we would have done the lap. I guess it depends on what you have insurance for versus what you are OOP for.
ReplyDeleteIf insurance covers the lap and you can clean out endo then you have a way better chance of getting KU with something like an IUI. If you don't have coverage where is your money better spent?
I should add that my insurance covered the lap totally but I have no IVF coverage. So for me it made sense to do the lap 1st and see if I could get KU with an IUI, then to rush to IVF where I would be totally OOP.
ReplyDelete